Healthcare Provider Details

I. General information

NPI: 1992377287
Provider Name (Legal Business Name): NORTH FLORIDA ANESTHESIA CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2021
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FLAGLER HEALTH WAY
ST JOHNS FL
32259-7166
US

IV. Provider business mailing address

PO BOX 745304
ATLANTA GA
30374-5304
US

V. Phone/Fax

Practice location:
  • Phone: 954-939-5000
  • Fax: 877-250-6888
Mailing address:
  • Phone: 954-939-5000
  • Fax: 877-250-6889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER KENNEDY
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 207-807-9009